| NPI | 1073869848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA7443) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2023-04-10 |