| NPI | 1174901003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 7698) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA pa60989637) |
| 363A00000X Physician Assistant (Licence: FL PA9113633) | |
| 363AM0700X Physician Assistant, Medical (Licence: OH 004328) | |
| 363A00000X Physician Assistant (Licence: NY 018589) | |
| 363A00000X Physician Assistant (Licence: VA 0110006085) | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2026-05-28 |