| NPI | 1083249916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007111) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-007111) |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2024-01-19 |