| NPI | 1073919197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006143) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005621) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2021-08-25 |