| NPI | 1457975286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA064380) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL 1173762) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2023-12-01 |