| NPI | 1801107834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002829A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA3173) |
| 363A00000X Physician Assistant (Licence: NC 001003167) | |
| 363A00000X Physician Assistant (Licence: MS PA00135) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2024-09-13 |