| NPI | 1669992277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 3694) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059077) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2020-12-15 |