| NPI | 1720319452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0006714) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000888) |
| 363A00000X Physician Assistant (Licence: VA 0110003851) | |
| 363A00000X Physician Assistant (Licence: OH 1088241) | |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2018-12-28 |