| NPI | 1306938816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1025) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001783) |
| 363A00000X Physician Assistant (Licence: WY 346) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2019-07-22 |