| NPI | 1811417264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 11909486-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: DC PA031370) | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-04-22 |