| NPI | 1720310956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00276) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004154) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2018-11-26 |