| NPI | 1902117997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA4119) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4119) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2020-01-07 |