| NPI | 1255437547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2231) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2194) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2023-06-08 |