| NPI | 1730296401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MD C0003336) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030440) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-06-11 |