| NPI | 1578969481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004780) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005612) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2022-03-28 |