| NPI | 1104185180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 9291448-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030842) |
| 363A00000X Physician Assistant (Licence: VA 0110003465) | |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2023-06-26 |