| NPI | 1952085029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006566) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA064652) |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2023-10-12 |