| NPI | 1881846947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 2312) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005454) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2020-07-10 |