| NPI | 1780374983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-2747) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-136407) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2024-08-28 |