| NPI | 1417907841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC A801) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 801) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-10-09 |