| NPI | 1578848735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03172) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2020-07-29 |