| NPI | 1255721395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 4626) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057389) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2023-06-19 |