| NPI | 1457584427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003122) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06353) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2026-01-23 |