| NPI | 1386112415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006309) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA TMA053225) |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2023-08-15 |