| NPI | 1285620567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002561) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0002911) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2018-03-17 |