| NPI | 1326382508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03833) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03833) |
| 363AM0700X Physician Assistant, Medical (Licence: SC PA1925) | |
| Enumeration Date | 2012-11-12 |
| Last Update Date | 2020-06-04 |