| NPI | 1659700128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056604) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2020-08-21 |