| NPI | 1306388202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06761) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2651) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2023-07-21 |