| NPI | 1376548982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA003622L) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003871) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-05-19 |