| NPI | 1831606748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059421) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004365) |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2020-02-17 |