| NPI | 1730386293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 225667) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002207) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2024-09-12 |