| NPI | 1356530067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030619) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003133) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 012113) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2025-05-13 |