| NPI | 1881971471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03218) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2020-05-01 |