| NPI | 1386021921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05555) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005696) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2023-04-03 |