| NPI | 1255388930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001008632) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50000765) |
| 363A00000X Physician Assistant (Licence: KS 1501132) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2023-02-20 |