| NPI | 1669631545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 001000089) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2023-03-07 |