| NPI | 1669005369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09467) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3537) |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2021-11-17 |