| NPI | 1205067428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04092) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1324) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2020-10-26 |