| NPI | 1003257361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04322) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2024-10-14 |