| NPI | 1770728834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 834) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 3960) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2024-10-13 |