| NPI | 1205146685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM 2010-0077) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054464) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2023-07-14 |