| NPI | 1679055685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09128) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 0010-09128) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2020-10-01 |