| NPI | 1609096692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA2539) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00986) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2022-07-21 |