| NPI | 1265490742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA052396) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052396) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-04-24 |