| NPI | 1780822379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200001595) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 12095) |
| 363A00000X Physician Assistant (Licence: VA 0110002910) | |
| 363A00000X Physician Assistant (Licence: TX PA17391) | |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2024-02-29 |