| NPI | 1316496524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 8171) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031285) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2024-12-02 |