| NPI | 1013139039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06830) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2986) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2024-02-21 |