| NPI | 1467126672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062689) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA005734) |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2021-10-05 |