| NPI | 1417288325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11127) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002432) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA54269) | |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2022-03-01 |