| NPI | 1447558622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05764) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1929) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2024-10-18 |