| NPI | 1861939464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7484) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3959-23) |
| Enumeration Date | 2017-01-21 |
| Last Update Date | 2020-10-09 |