| NPI | 1922562834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 0010-08851) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2021-08-04 |