| NPI | 1104381060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-006553) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007442) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2023-04-19 |