| NPI | 1154600526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03053) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2022-03-29 |