| NPI | 1598082489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA1098) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00127) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2023-07-03 |