| NPI | 1306939350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VI 15) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 00110002060) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-05-23 |