| NPI | 1851723639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MA PA4790) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2019-06-23 |