| NPI | 1881092237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006478) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057333) |
| 363A00000X Physician Assistant (Licence: MD C0005651) | |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2022-04-11 |