| NPI | 1295094035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 006076) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006420) |
| 363A00000X Physician Assistant (Licence: TX PA09689) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2023-07-14 |