| NPI | 1336209279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051164) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9107854) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2021-03-24 |