| NPI | 1043393200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 103212) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2023-07-05 |