| NPI | 1952463473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12620) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1137) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2022-10-24 |