| NPI | 1295923910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08612) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001008612) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2024-12-02 |