| NPI | 1750798492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031066) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9704) |
| 363A00000X Physician Assistant (Licence: NC 0010-10793) | |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2024-01-11 |