| NPI | 1528084357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00309) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 100309) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-05-16 |