| NPI | 1437424660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 1099698) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 22306) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2021-10-07 |