| NPI | 1568864189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004713) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: 0110004713) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2019-03-01 |