| NPI | 1770191405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 323733) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2021-05-26 |