| NPI | 1285884007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003714) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01553) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2024-03-28 |