| NPI | 1366684318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01931) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005603) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2024-05-06 |