| NPI | 1396813788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 113683) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00536) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2022-10-05 |