| NPI | 1982634762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02297) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002137) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-08-20 |