| NPI | 1811556541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL 9112212) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2023-08-31 |