| NPI | 1750908380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10311) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3616) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |