| NPI | 1942508767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 001002785) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: NC 001002785) | |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2024-05-24 |