| NPI | 1164518254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002308) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002308) |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110002308) | |
| 363A00000X Physician Assistant (Licence: TN 1813) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2025-09-17 |