| NPI | 1538353057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024033212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004396) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2024-11-06 |