| NPI | 1326357864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003409) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004341) |
| 363AS0400X Physician Assistant, Surgical (Licence: DC PA030701) | |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2021-10-19 |