| NPI | 1902100134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09610) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2024-12-18 |