| NPI | 1699130310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110007155) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0001162) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2020-08-11 |