| NPI | 1093967887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 1353) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC TL1353) |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2020-11-09 |