| NPI | 1952369100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110001949) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001000355) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2022-01-20 |