| NPI | 1497161954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004654) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: VA 0110004654) |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2025-10-09 |