| NPI | 1700358694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-08777) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08777) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 1140871) | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2022-08-09 |