| NPI | 1801469028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA.2163) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116559) |
| Enumeration Date | 2021-07-24 |
| Last Update Date | 2024-01-03 |