| NPI | 1841236353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103743) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 363A00000X) |
| 363AM0700X Physician Assistant, Medical (Licence: MA PA2582) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-12-02 |