| NPI | 1801278833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA15747) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: PA MA057695) | |
| 363AM0700X Physician Assistant Medical | |
| 363AM0700X Physician Assistant Medical (Licence: PA MA057695) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2023-01-28 |