| NPI | 1851023980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2785) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 114801) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-07-13 |