| NPI | 1992306344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2301) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR 202078) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2022-10-05 |