| NPI | 1477980449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08060) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006972) |
| 363A00000X Physician Assistant (Licence: GA 2574) | |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2021-10-19 |