| NPI | 1912677006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11634) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 27665) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2023-07-17 |