| NPI | 1952553935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110002921) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: VA 0110002921) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2017-04-06 |