| NPI | 1871542506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2638) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002133) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 2638) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-03-02 |