| NPI | 1467002634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001296) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4595) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 4595) | |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2024-02-13 |