| NPI | 1316330525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006465) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52331) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2019-10-30 |