| NPI | 1083037626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00704) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 337806) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2024-08-01 |