| NPI | 1689743700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2217) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1535) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2023-03-14 |