| NPI | 1093034704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004926) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2015-05-21 |