| NPI | 1306920277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2007002748) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001771) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-09-08 |