| NPI | 1972869592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-478) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2023007996) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2023-05-10 |