| NPI | 1205268448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05528) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005069) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2018-12-13 |