| NPI | 1508189184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006137) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2288) |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2018-12-26 |