| NPI | 1467040378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024027698) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00653) |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2024-10-23 |