| NPI | 1942552948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-004899) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001003868) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2022-01-06 |