| NPI | 1649550054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031020) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10118) |
| 363A00000X Physician Assistant (Licence: TX PA17302) | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2025-03-17 |