| NPI | 1164854758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058162) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MA058162) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2018-11-20 |