| NPI | 1518366913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 075152) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 075152) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2021-02-08 |