| NPI | 1700432036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 10-10737) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2021-01-15 |