| NPI | 1083369904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008432) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2024-03-06 |