| NPI | 1740248285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003548) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C02324) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-03-08 |