| NPI | 1003335266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3086) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07603) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2018-11-12 |