| NPI | 1780171462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2018021507) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2015021230) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-07-19 |