| NPI | 1912741620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 5398) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 1207410) |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-09-10 |