| NPI | 1497183156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05080) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4842) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2019-04-10 |