| NPI | 1144646977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056750) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003260) |
| 363A00000X Physician Assistant (Licence: DE C5-0012127) | |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2024-11-29 |