| NPI | 1316217706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004951) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055333) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2021-06-15 |