| NPI | 1700034394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004389) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2573) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2020-04-08 |