| NPI | 1194361451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008027) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK 3120) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2023-05-30 |