| NPI | 1700386711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09851) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006949) |
| 363A00000X Physician Assistant (Licence: VA 0110006078) | |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2025-06-09 |