| NPI | 1376893503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 002330) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0004847) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2022-08-02 |