| NPI | 1740724343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA OA004021) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA058794) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2023-11-28 |