| NPI | 1174640890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001000971) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004163) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2023-08-07 |