| NPI | 1952078198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13226) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4294) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2023-08-30 |