| NPI | 1427727965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-102109) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2021-09-26 |