| NPI | 1538792031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA005194) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: PA MA061485) | |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2024-06-07 |