| NPI | 1811964398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103128) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 103128) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2022-11-10 |