| NPI | 1205257961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004478) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2021-06-24 |