| NPI | 1083068167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110005308) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 2979) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2024-12-13 |