| NPI | 1538590591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1979) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2023-06-14 |