| NPI | 1861817678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-132011) |
| 363AM0700X Physician Assistant Medical | |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2017-03-31 |