| NPI | 1700372323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA3543) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08191) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2020-05-28 |