| NPI | 1487095956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC TL3246) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 6862) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2019-06-18 |