| NPI | 1669148219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA005763) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062749) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2022-04-06 |