| NPI | 1689727141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MD C0002828) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002051) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2021-10-15 |