| NPI | 1659062149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023008590) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2023008590) |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-07-05 |