| NPI | 1891034856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008551) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04003) |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2023-08-25 |