| NPI | 1891995676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1884) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001000967) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2020-12-10 |