| NPI | 1811642804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 198839) |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2024-07-29 |