| NPI | 1407636830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA065076) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA006685) |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2024-08-22 |