| NPI | 1770969131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C05839) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-10529) |
| 363A00000X Physician Assistant (Licence: DC PA031239) | |
| 363A00000X Physician Assistant (Licence: VA 0110007406) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2023-05-14 |