| NPI | 1386800258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110002422) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MD C0003428) |
| 363AM0700X Physician Assistant Medical (Licence: DC PA030459) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2024-04-04 |