| NPI | 1942578414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA055184) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002751) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2022-12-02 |