| NPI | 1659896264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 2969) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NC 228543) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2023-03-30 |