| NPI | 1447537683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110011472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4818) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2026-04-03 |