| NPI | 1861747073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-006856) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016008) |
| 363A00000X Physician Assistant (Licence: WA PA031352) | |
| 363A00000X Physician Assistant (Licence: CA 51366) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2023-06-06 |