| NPI | 1922348556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058951) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004985) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA058951) | |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2022-08-10 |