| NPI | 1841541158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MS PA00343) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003996) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2022-10-18 |