| NPI | 1215278429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2016027984) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001004094) |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2019-02-18 |