| NPI | 1578912424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005892) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06236) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2018-03-17 |