| NPI | 1679810931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1092) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0844) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2022-04-29 |