| NPI | 1578784070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2010011175) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-06-02 |