| NPI | 1316308091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006452) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06383) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2025-10-29 |