| NPI | 1730449638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03566) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2132) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2023-11-27 |