| NPI | 1245326909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA001541L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002348) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-11-05 |