| NPI | 1508474958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 324111) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2023-02-02 |