| NPI | 1932148970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 282) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 283) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2021-06-30 |