| NPI | 1306817796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 007673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PW MA052131) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2020-01-06 |