| NPI | 1740488832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05759) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 123952) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2024-05-02 |