| NPI | 1649844622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 59434) |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2021-11-04 |