| NPI | 1962978502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57768) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031534) |
| 363A00000X Physician Assistant (Licence: VA 0110006322) | |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2020-02-18 |