| NPI | 1033509229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110004894) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2015-04-16 |