| NPI | 1326001488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA1195) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1195) |
| 363AM0700X Physician Assistant, Medical (Licence: MA 1195) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2021-07-15 |