| NPI | 1679210421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-12369) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2022-08-31 |