| NPI | 1548745672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08567) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC Pending) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-08567) | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2023-09-19 |