| NPI | 1730189861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT 40815) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK apa1318) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2023-11-27 |