| NPI | 1346784949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 104221) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 6462) |
| 363A00000X Physician Assistant (Licence: NH 1227) | |
| 363A00000X Physician Assistant (Licence: SC 3623) | |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2022-02-03 |