| NPI | 1669876645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7948) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057264) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2023-12-22 |