| NPI | 1245332337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WY md1123075) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 8722) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2024-02-01 |