| NPI | 1164456083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1354) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 103691) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2024-05-20 |