| NPI | 1891708715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110840363) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 2359) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-03-11 |