| NPI | 1831580430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006038) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003293) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2018-05-10 |