| NPI | 1881927796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MA PA4862) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA054049) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2018-08-01 |