| NPI | 1366561961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051904) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002006) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-07-10 |