| NPI | 1376198564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-80467) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2024-02-19 |