| NPI | 1982975454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA006847) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA056041) |
| Enumeration Date | 2012-01-15 |
| Last Update Date | 2024-07-25 |