| NPI | 1700181658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006007) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001002579) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2020-06-11 |