| NPI | 1124466644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004216) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005035) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2025-01-29 |