| NPI | 1184753063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 1507) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC TL1507) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA002063L) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2022-11-02 |