| NPI | 1881086742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05608) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 0010-05608) |
| 363AM0700X Physician Assistant Medical (Licence: NC 0010-05608) | |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2022-11-08 |