| NPI | 1679288534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC PA4805) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2024-03-28 |