| NPI | 1982924486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04504) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 5816) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2018-10-22 |