| NPI | 1629202080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1553) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005582) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2021-01-28 |