| NPI | 1497269534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09865) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6334) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2024-06-17 |