| NPI | 1144207473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 003734) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC PA1125) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2018-12-13 |