| NPI | 1306286117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 7469) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 2501) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 6857) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2021-09-14 |