| NPI | 1730153313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003017) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003738) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2025-11-19 |