| NPI | 1518485101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001275) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023869) |
| 363A00000X Physician Assistant (Licence: AZ 6823) | |
| 363A00000X Physician Assistant (Licence: GA 11849) | |
| Enumeration Date | 2017-09-02 |
| Last Update Date | 2024-01-11 |