| NPI | 1154860724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005682) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027833) |
| 363A00000X Physician Assistant (Licence: CA PA63108) | |
| 363A00000X Physician Assistant (Licence: DC PA031568) | |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2024-06-06 |