| NPI | 1669984019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059518) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004340) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2018-03-17 |