| NPI | 1447628458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006865) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7125) |
| 363A00000X Physician Assistant (Licence: TN 2840) | |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2020-01-06 |