| NPI | 1962917922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA 329438) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AR PA-754) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2022-01-04 |