| NPI | 1831667567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007225) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9078) |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2020-07-08 |