| NPI | 1780284844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 126133) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: MA PA8774) | |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2024-09-09 |