| NPI | 1932457405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012198) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006806) |
| 363A00000X Physician Assistant (Licence: WA PA60663086) | |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2025-02-12 |