| NPI | 1770998288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 074554) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2023-10-09 |