| NPI | 1710166632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA PENDING) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002695) |
| 363A00000X Physician Assistant (Licence: AZ 103770) | |
| 363A00000X Physician Assistant (Licence: CA 64515) | |
| Enumeration Date | 2007-10-27 |
| Last Update Date | 2025-02-04 |