| NPI | 1497821573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 1630) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 1236) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2016-03-11 |