| NPI | 1982701942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3417) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA050776) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-03-01 |