| NPI | 1710310941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030973) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10951) |
| 363A00000X Physician Assistant (Licence: MD C0005136) | |
| 363A00000X Physician Assistant (Licence: GA 9701) | |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2024-01-11 |