| NPI | 1043478944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01038) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 1719) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2022-05-21 |