| NPI | 1720539000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 51232) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-2267) |
| 363A00000X Physician Assistant (Licence: ND PAC1065) | |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2024-01-24 |