| NPI | 1265972202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09207) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2022-03-22 |