| NPI | 1659763878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057492) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003509) |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2023-07-12 |