| NPI | 1265986715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09515) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C06177) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2021-08-07 |