| NPI | 1093147498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6859) |
| 363A00000X Physician Assistant (Licence: MD C06780) | |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2024-03-25 |