| NPI | 1659503993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005789) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD c0003188) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2022-07-08 |