| NPI | 1689186157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004324) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059490) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2020-01-29 |