| NPI | 1821610585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061079) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005028) |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-12-17 |