| NPI | 1699231563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C07477) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA200001321) |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2025-02-13 |