| NPI | 1710359237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003687) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057987) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2020-08-30 |