| NPI | 1679903561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9118463) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE c5-0000914) |
| 363A00000X Physician Assistant (Licence: VA 0110005022) | |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2024-05-09 |