| NPI | 1033744222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007286) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208800000X Urology (Licence: VA 0110-007286) | |
| Enumeration Date | 2020-03-08 |
| Last Update Date | 2026-06-27 |