| NPI | 1952544132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1416) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-0766) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2023-12-13 |