| NPI | 1851808067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT 104109) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1927) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2023-10-06 |