| NPI | 1912437815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2135) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2135) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2018-05-11 |