| NPI | 1063847051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031145) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: GA 11556) | |
| 363A00000X Physician Assistant (Licence: TX PA17390) | |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2024-05-30 |