| NPI | 1568479285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05736) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001728) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2022-02-10 |