| NPI | 1154418002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01065) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3173) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-03-29 |