| NPI | 1679132039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA006816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD C0007213) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-04-05 |