| NPI | 1962949917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 121498) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2097) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2024-11-21 |