| NPI | 1346567203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04816) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053924) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2024-03-05 |