| NPI | 1720084569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SD 0543) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2018-10-01 |