| NPI | 1558736603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006372) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006090) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2020-06-11 |