| NPI | 1285970236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04451) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2023-10-05 |