| NPI | 1336640333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 10-09613) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021773) |
| Enumeration Date | 2018-02-24 |
| Last Update Date | 2021-11-04 |