| NPI | 1356990758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-007467) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2020-09-23 |