| NPI | 1366413890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006367) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051211) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2023-01-26 |