| NPI | 1356890347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61201) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031306) |
| 363A00000X Physician Assistant (Licence: VA 0110-005523) | |
| Enumeration Date | 2016-10-02 |
| Last Update Date | 2022-09-29 |