| NPI | 1265990535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08923) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 0010-08923) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2020-10-26 |