| NPI | 1942633433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-06659) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2023-06-22 |