| NPI | 1548629967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06246) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 215358) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2022-05-17 |