| NPI | 1679570659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001570) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 899) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2024-08-14 |