| NPI | 1689425324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 342880) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2024-03-29 |
| Last Update Date | 2024-07-23 |