| NPI | 1225278609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 002206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1430) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2023-05-11 |