| NPI | 1184767006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008437) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2022-05-20 |