| NPI | 1477838910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 1729) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2384) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2023-12-05 |