| NPI | 1790110898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1755) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002434) |
| Enumeration Date | 2013-09-08 |
| Last Update Date | 2023-05-10 |