| NPI | 1689162406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: DC PA031732) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA059716) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2024-04-25 |