| NPI | 1316903487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052132) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052132) |
| 363A00000X Physician Assistant (Licence: VA 0110002153) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-11-07 |