| NPI | 1922533439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12354) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002681A) |
| Enumeration Date | 2017-04-22 |
| Last Update Date | 2023-11-13 |