| NPI | 1205457033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007697) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-007697) |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2025-09-05 |