| NPI | 1568908176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06946) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06946) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-06946) | |
| Enumeration Date | 2017-01-07 |
| Last Update Date | 2022-09-21 |