| NPI | 1336111046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 003272) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 3272) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2023-08-17 |