| NPI | 1093370348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-007018) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2024-03-07 |