| NPI | 1932270204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD475435) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT216923) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA052456) | |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2021-08-31 |