| NPI | 1306381702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 2647) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC MPA2647PA) |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2020-11-10 |