| NPI | 1407201833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008315) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MP 096) |
| 363A00000X Physician Assistant (Licence: MD C0007287) | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2023-08-10 |