| NPI | 1477910537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA MA6390) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1688) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2020-03-02 |