| NPI | 1326589599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA100245) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001011589) |
| 363A00000X Physician Assistant (Licence: VA 0110005708) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-12-12 |