| NPI | 1346759818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3047) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005849) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2018-12-20 |