| NPI | 1386280071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA005070) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA061231) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2020-04-07 |