| NPI | 1396943999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-108187) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01673) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-07-14 |