| NPI | 1760865083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08075) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 2965) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 019004) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-08075) | |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2021-10-15 |