| NPI | 1851395198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 101831) |
| 363A00000X Physician Assistant (Licence: NC 101831) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-10-27 |