| NPI | 1649218470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2012016947) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2012016947) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2024-04-25 |