| NPI | 1316250590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004053) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 1853) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2022-02-01 |