| NPI | 1023042702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2998) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 004671) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-03-07 |