| NPI | 1285820738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 1240) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC LL1240) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2022-09-28 |