| NPI | 1588312011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC MPA-4205) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4205) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2024-02-05 |