| NPI | 1154693729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 32466) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1326) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2023-11-27 |