| NPI | 1649927757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-130439) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL 1942) |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2023-12-05 |