| NPI | 1831748904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-006652) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |