| NPI | 1588221394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10028) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-006527) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2020-08-05 |