| NPI | 1801812011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA1219) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002023) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-11-28 |