| NPI | 1750891511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004183) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058990) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2024-06-13 |