| NPI | 1306920046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00638) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7521-23) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-01-31 |