| NPI | 1770910440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: DC PA031083) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031083) |
| 363AM0700X Physician Assistant Medical (Licence: MD C0005211) | |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2024-02-28 |