| NPI | 1487969630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07117) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2894) |
| 363A00000X Physician Assistant (Licence: VA 0110003389) | |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2022-05-02 |