| NPI | 1588790109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 103910) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-10-12 |