| NPI | 1679055628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL 1682) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-08336) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2023-06-30 |