| NPI | 1871886697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-003928) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004790) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2016-12-04 |