| NPI | 1730320607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0101235679) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002977) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110002977) | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2023-06-27 |