| NPI | 1891705612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 1670) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 01670) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2023-09-25 |