| NPI | 1710510771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9076) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA200001253) |
| 363A00000X Physician Assistant (Licence: NV PA2295) | |
| 363A00000X Physician Assistant (Licence: FL PA9112996) | |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2023-02-09 |