| NPI | 1427334697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 36942) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 8098517-1206) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2023-11-27 |