| NPI | 1326587502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07106) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3200) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-04-26 |