| NPI | 1366878951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3421) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4700) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2020-02-18 |