| NPI | 1659556892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: SC 599) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2022-12-19 |