| NPI | 1053894493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 011000636) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006935) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2024-04-01 |