| NPI | 1043276504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00227) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA PA.A10440.RX) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2023-05-10 |