| NPI | 1881345817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-2507) |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2023-06-05 |