| NPI | 1770716797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003061) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003061) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2024-02-16 |