| NPI | 1427329275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006336) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055321) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2024-02-21 |