| NPI | 1124638986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007721) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2021-06-21 |