| NPI | 1679970909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003481) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057377) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2022-09-20 |