| NPI | 1861702797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006591) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110006591) |
| 363A00000X Physician Assistant (Licence: NC 0010-02574) | |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2024-01-05 |