| NPI | 1366488363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MD C02514) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9102663) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2018-11-16 |