| NPI | 1750978326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005301) |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2021-03-08 |