| NPI | 1487680435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA ma003454l) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA000712) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-03-03 |