| NPI | 1811697543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MS 74068) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: MS A079849) |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2023-03-26 |