| NPI | 1023044906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3509) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051653) |
| 363A00000X Physician Assistant (Licence: VA 0110001232) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2020-04-14 |