| NPI | 1447589544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA054087) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002400) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2018-08-08 |