| NPI | 1386084572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031171) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004298) |
| 363A00000X Physician Assistant (Licence: GA 11108) | |
| 363A00000X Physician Assistant (Licence: NC 0010-12147) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2024-01-11 |