| NPI | 1407881196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 842) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 10002) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-03-07 |