| NPI | 1396093837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA200582) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 200582) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2023-08-17 |