| NPI | 1942488374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 103810) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2014-11-18 |