| NPI | 1881684165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053459) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002162) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-07-13 |