| NPI | 1396126330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110005013) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WV 2078) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2023-03-07 |