| NPI | 1578198818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 1594) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2023-05-16 |