| NPI | 1013308972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110004854) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MD C0005711) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2024-05-22 |