| NPI | 1144691767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110008989) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: VA 0110008989) | |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2023-02-14 |