| NPI | 1417484965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0006476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058996) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-08-16 |