| NPI | 1134385925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006901) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053409) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA053409) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2024-10-15 |