| NPI | 1285768291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00512) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2716) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2022-03-29 |