| NPI | 1609277342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05196) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NC 0010-05196) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2019-04-09 |