| NPI | 1821624370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00646) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1595) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2023-05-25 |