| NPI | 1831569607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA003661) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057942) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2022-07-21 |