| NPI | 1417048455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 0662) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001829) |
| 363A00000X Physician Assistant (Licence: NE 1396) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-07-21 |