| NPI | 1740701598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6717) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1671) |
| Enumeration Date | 2017-07-02 |
| Last Update Date | 2022-07-29 |