| NPI | 1245224534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 102169) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 102169) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2024-04-17 |