| NPI | 1619429859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058573) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MX037883) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2022-09-14 |