| NPI | 1033660741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001010584) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058551) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2024-05-08 |