| NPI | 1619017811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00527) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 001000527) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2024-12-09 |