| NPI | 1912925603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2004000619) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2024-02-07 |