| NPI | 1558774927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA056881) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2021-08-13 |