| NPI | 1881160638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2021033601) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 5473) |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2021-08-26 |