| NPI | 1598947111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003987) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0003485) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2023-07-21 |