| NPI | 1457780629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056407) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C05246) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2019-04-02 |