| NPI | 1326091919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1060) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1367) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-02-21 |