| NPI | 1144779307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010290) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53830) |
| 363A00000X Physician Assistant (Licence: AZ 8335) | |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2025-06-27 |