| NPI | 1851986798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA9402) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA062375) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2023-07-17 |