| NPI | 1265799779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004335) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03418) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2017-09-14 |