| NPI | 1629601224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-008804) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 027201) |
| 363A00000X Physician Assistant (Licence: MD C0008632) | |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2023-02-20 |