| NPI | 1871258756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10471) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4171) |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2024-06-25 |