| NPI | 1689175093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 090876) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2218) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |