| NPI | 1518334259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004578) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2021-01-09 |