| NPI | 1306288485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC MPA4986PA) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2024-01-16 |