| NPI | 1417592932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061229) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 339130) |
| 363A00000X Physician Assistant (Licence: PA OA005090) | |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2024-12-13 |