| NPI | 1013321876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2125) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2021-02-04 |