| NPI | 1922546324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12495) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9110077) |
| 363A00000X Physician Assistant (Licence: CA PA56983) | |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2023-01-05 |