| NPI | 1073593141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051422) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA000943) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-01-24 |