| NPI | 1871136176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10319) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3588) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2021-03-29 |