| NPI | 1578715421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 2274) |
| 363A00000X Physician Assistant (Licence: CA 20465) | |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2021-12-06 |