| NPI | 1679026231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 2837) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WY PA962) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2024-06-14 |