| NPI | 1740679539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05510) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2021-03-31 |