| NPI | 1992940522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110-004802) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110004802) |
| 207R00000X Internal Medicine (Licence: VA 0110004802) | |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2019-07-02 |