| NPI | 1154706794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005116) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05864) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2020-04-22 |