| NPI | 1982658662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC BLC1791174) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA001688L) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2023-12-06 |