| NPI | 1417467408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07636) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 0010-07636) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2018-04-04 |