| NPI | 1851053482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4692) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2024-08-28 |