| NPI | 1447456074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 010002446) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005591) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2016-05-16 |