| NPI | 1134521271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110007120) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05910) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2023-03-07 |