| NPI | 1740208297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 001000198) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 1039) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-05-11 |