| NPI | 1548768104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0008245) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2198) |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2024-03-05 |