| NPI | 1487649091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10929) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PAA10607 RX) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2025-05-05 |