| NPI | 1710521687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2411) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 099349) |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2020-03-02 |