| NPI | 1043388739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02053) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 0010-02053) |
| 363A00000X Physician Assistant (Licence: AK 724) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02053) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2024-06-13 |