| NPI | 1457817173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12226) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3155) |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2023-03-24 |