| NPI | 1700109584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA463) |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2024-04-26 |