| NPI | 1003847286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA1068) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00456) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 1068) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00456) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-10-31 |