| NPI | 1669936423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 2316) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2021-11-05 |