| NPI | 1205099785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA2554) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA AP2554) |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2019-01-30 |