| NPI | 1740605229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-04837) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007289) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2023-10-30 |