| NPI | 1235949678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110011565) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: VA 0110011565) |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2026-04-03 |