| NPI | 1548572589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007281) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX 02041) |
| 363AM0700X Physician Assistant, Medical (Licence: OR PA193360) | |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2025-03-13 |