| NPI | 1508449893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2601) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 100806) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2023-09-28 |