| NPI | 1548578818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06445) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21187) |
| 363A00000X Physician Assistant (Licence: MA PA4641) | |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2021-03-31 |