| NPI | 1720358070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 2251) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03197) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2017-03-09 |