| NPI | 1982005583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003406) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06685) |
| 363A00000X Physician Assistant (Licence: PA MA057229) | |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2021-01-05 |