| NPI | 1912428772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10201) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-07-02 |
| Last Update Date | 2020-11-11 |