| NPI | 1528412715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008926) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06422) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2023-08-10 |