| NPI | 1366062176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9115019) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.2177) |
| 363AM0700X Physician Assistant, Medical (Licence: 9115019) | |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2023-05-15 |