| NPI | 1851351563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001412) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 1412) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2021-12-21 |