| NPI | 1548630924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005105) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA56663) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2019-05-17 |