| NPI | 1457761736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04653) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2456) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2022-04-25 |