| NPI | 1932646205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006633) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06978) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2025-02-19 |