| NPI | 1770733289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08334) |
| 363A00000X Physician Assistant (Licence: VA 0110007908) | |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2024-06-14 |