| NPI | 1043611460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010921) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2025-05-28 |