| NPI | 1396901633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02756) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WV 423) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2019-10-03 |