| NPI | 1851642821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03685) |
| Enumeration Date | 2012-09-30 |
| Last Update Date | 2020-02-14 |