| NPI | 1194231449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006020) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0110006020) |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110006020) | |
| Enumeration Date | 2017-12-22 |
| Last Update Date | 2024-10-31 |