| NPI | 1073929329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004663) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06530) |
| 363A00000X Physician Assistant (Licence: WA PA60858482) | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2024-11-25 |