| NPI | 1609887694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VI 0110001216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD 0110001216) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2012-02-09 |