| NPI | 1285982652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SD 1434) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 002306) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2024-07-08 |