| NPI | 1023101680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001498) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 103791) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2025-02-19 |