| NPI | 1770066110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 3071) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2022-03-01 |