| NPI | 1568577922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001000457) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-08-25 |