| NPI | 1487741468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110006858) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC 030445) |
| 363AM0700X Physician Assistant Medical (Licence: GA 6532) | |
| 363AM0700X Physician Assistant Medical (Licence: MD C03573) | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2022-12-10 |