| NPI | 1356782478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008487) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007942) |
| 363A00000X Physician Assistant (Licence: DC PA031946) | |
| 363A00000X Physician Assistant (Licence: OH 50.004641RX) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2024-06-06 |