| NPI | 1023217338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5103) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 104112) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2024-10-30 |