| NPI | 1053089045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008757) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0008042) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-06-07 |