| NPI | 1245250703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-198) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 198) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-04-10 |