| NPI | 1649412420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C07530) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104794) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2022-10-07 |