| NPI | 1417401670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06639) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001006639) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2021-12-27 |