| NPI | 1427703545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023042548) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10844) |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2024-07-31 |