| NPI | 1104071034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001001606) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2024-06-05 |