| NPI | 1558357806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR 1239) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001321) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2024-03-05 |