| NPI | 1306800560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MA 672) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 672) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2020-10-27 |