| NPI | 1700431616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 313108) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 313108) |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2022-01-03 |