| NPI | 1518328533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC pending) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005282) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2021-11-05 |