| NPI | 1164741724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08771) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 5785) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2024-01-11 |