| NPI | 1265527626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA 053800) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA OA002338) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-04-17 |