| NPI | 1861966830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3117) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC PA3117) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2020-02-25 |