| NPI | 1922698612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8359) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9113709) |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2021-03-16 |