| NPI | 1841307816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01810) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 562) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2023-07-25 |