| NPI | 1710088208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1060) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID RPA-164) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-04-27 |