| NPI | 1982299871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14654) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5139) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2024-10-28 |