| NPI | 1073218707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009783) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-02-19 |