| NPI | 1598274797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4206-23) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2021-01-14 |