| NPI | 1780231340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5301) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09090) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2024-08-13 |