| NPI | 1013982917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2263) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 102568) |
| 363LF0000X Nurse Practitioner Family (Licence: SC 2263) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-04-10 |