| NPI | 1013914837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06301) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06301) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-09-22 |