| NPI | 1356989891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 117263) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA197457) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2024-01-02 |