| NPI | 1447714704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11800) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3788) |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2022-02-07 |