| NPI | 1598851677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07982) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002381) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-02-27 |