| NPI | 1417984675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001816) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 103991) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2024-04-03 |