| NPI | 1629437660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 340826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058115) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2024-06-24 |