| NPI | 1134637846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006029) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007492) |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2022-11-29 |