| NPI | 1588658363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 004605) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 4605) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2019-05-23 |