| NPI | 1528356847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6866) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03711) |
| 363A00000X Physician Assistant (Licence: VA 0110003631) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2024-04-25 |