| NPI | 1417006115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00315) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 200500264) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2023-11-22 |