| NPI | 1770767683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8620) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1088) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2023-05-30 |