| NPI | 1417063025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA2268) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 000647) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-01-05 |