| NPI | 1821480450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 211987) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 8325) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2025-01-21 |