| NPI | 1770209181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12800) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2024-04-23 |