| NPI | 1700134806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-12271) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 4550) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2022-07-30 |