| NPI | 1184691776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA050731) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA001011) |
| 363A00000X Physician Assistant (Licence: PA MA050731) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-06-08 |