| NPI | 1619218211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2750) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2013005285) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2024-02-06 |