| NPI | 1992109193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11882) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031529) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110-004749) | |
| Enumeration Date | 2014-10-16 |
| Last Update Date | 2023-07-17 |