| NPI | 1770143588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 9287) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9287) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2019-07-12 |