| NPI | 1174640528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 001795) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1319) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2021-06-14 |