| NPI | 1093184848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005769) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C05914) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2025-02-14 |