| NPI | 1144275165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103683) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 103683) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-11-15 |