| NPI | 1699167676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004777) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005618) |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2021-03-20 |