| NPI | 1881385136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023025065) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2903) |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-09-13 |