| NPI | 1407914989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA001066L) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA001066L) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-01-31 |