| NPI | 1558061796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2896) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 118875) |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2023-03-07 |