| NPI | 1861914368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2017036199) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2021-11-03 |