| NPI | 1396142048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MD C0006492) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VA 0110008403) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2024-06-06 |