| NPI | 1720007198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NV PA 1020) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 006367-1) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-05-30 |