| NPI | 1447915012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006108) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062782) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2024-01-02 |