| NPI | 1578152427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-94043) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV 1176977) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-11-11 |