| NPI | 1699821819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C05868) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052829) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2023-09-17 |