| NPI | 1508104993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0004964) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1696) |
| Enumeration Date | 2013-01-21 |
| Last Update Date | 2020-12-10 |