| NPI | 1609079359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002070) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA066488) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2025-04-18 |