| NPI | 1598852238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 103332) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-06-30 |