| NPI | 1689330441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA100076) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61256879) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2024-03-18 |