| NPI | 1285146217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07715) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005971) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2024-03-05 |