| NPI | 1750525531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006638) |
| Additional Taxonomies | 1710I1003X Military Health Care Provider Independent Duty Medical Technicians |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2023-05-04 |