| NPI | 1205376324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 095448) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2017003635) |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2019-05-08 |