| NPI | 1619004801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 3312) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA 002171-L) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2022-01-19 |