| NPI | 1821387325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 1644) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NC 0010-02811) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2022-01-18 |