| NPI | 1457909475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC CA210001343) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7897) |
| 363A00000X Physician Assistant (Licence: NC 0010-09410) | |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2021-11-17 |