| NPI | 1750492765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA002335L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA000765) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-09-21 |