| NPI | 1568898369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056468) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003145) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2020-04-06 |