| NPI | 1700097383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001613) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 010253942) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2021-09-13 |