| NPI | 1861794786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA1605) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC TL1605) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2019-01-22 |