| NPI | 1659968451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10977) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2023-08-10 |