| NPI | 1265468060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13648) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8208) |
| 363A00000X Physician Assistant (Licence: NY 007505-1) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2023-12-02 |