| NPI | 1780988600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SD 1095) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 002161) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2022-04-08 |