| NPI | 1407973027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1825) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00422) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00422) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2023-03-07 |