| NPI | 1104877281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001290) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1973) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2021-06-14 |