| NPI | 1982274072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA005698) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA062614) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-06-30 |