| NPI | 1528306214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-006147) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016274-1) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2018-11-13 |