| NPI | 1417292848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA055892) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003310) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2020-12-24 |