| NPI | 1982453254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA 343160) |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-08-19 |