| NPI | 1942800370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14558) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2024-09-17 |