| NPI | 1487136461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 77899) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1155) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2021-11-11 |