| NPI | 1386815835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9109966) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2008006639) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2019-04-03 |