| NPI | 1679856751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA200502) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 200502) |
| Enumeration Date | 2011-09-24 |
| Last Update Date | 2023-06-15 |