| NPI | 1861494635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051755) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AR PA-321) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2021-03-10 |