| NPI | 1811948797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MAO53052) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 21091) |
| 363A00000X Physician Assistant (Licence: PA OA000938) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2021-09-13 |