| NPI | 1073961744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06562) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2022-07-20 |