| NPI | 1346641479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008038) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 074895) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2022-07-18 |