| NPI | 1679513873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA002299) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA002359) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-09-12 |