| NPI | 1679587448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51551) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA791) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-01-11 |