| NPI | 1316184195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0526) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC081) |
| 363A00000X Physician Assistant (Licence: TN 1626) | |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2022-04-18 |