| NPI | 1386116226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PENDING) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8046) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 3187) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2025-01-17 |