| NPI | 1306331558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059833) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |