| NPI | 1851522510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 010003077) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003077) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2018-09-18 |