| NPI | 1720209471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA003560L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA-003560-L) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2024-06-24 |