| NPI | 1871843466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005358) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004845) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2017-03-21 |