| NPI | 1083082838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12764) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2837) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2023-03-09 |