| NPI | 1497191175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 3056) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056065) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2022-03-01 |