| NPI | 1962584953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02346) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1268) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2018-12-31 |