| NPI | 1114426392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006077) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110006077) |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2023-11-27 |