| NPI | 1093147498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06780) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2026-04-24 |