| NPI | 1093142283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04524) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 195581) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2021-05-06 |