| NPI | 1720328248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00622) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22802) |
| 363A00000X Physician Assistant (Licence: NC 0010-09475) | |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2022-09-01 |