| NPI | 1548706286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110005618) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005618) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2018-08-10 |