| NPI | 1588890644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002967) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004722) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2019-02-22 |