| NPI | 1558916239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MA060848) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060848) |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2023-11-28 |