| NPI | 1972234763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006120) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA063630) |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-07-11 |