| NPI | 1396754008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 14181147-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VT 055-0030622) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2025-01-10 |