| NPI | 1841260270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08558) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052599) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2021-05-26 |