| NPI | 1518381482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2484) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005328) |
| 363A00000X Physician Assistant (Licence: SC TL2484) | |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2021-01-27 |