| NPI | 1528093341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002750) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 103896) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-02-05 |