| NPI | 1265953889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006291) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2019-07-03 |