| NPI | 1477815017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009459) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001003569) |
| 363A00000X Physician Assistant (Licence: NY 0170981) | |
| 363A00000X Physician Assistant (Licence: DC PA200001994) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2024-09-12 |