| NPI | 1184109837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060186) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA004639) |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2018-09-28 |