| NPI | 1386942381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02744) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2450) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2022-09-21 |