| NPI | 1407044803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA053188) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA OA006611) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2025-03-26 |