| NPI | 1265835581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C05861) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL PA.992) |
| 363AM0700X Physician Assistant, Medical (Licence: CA 59695) | |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2023-11-09 |