| NPI | 1255970414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006944) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0110006944) |
| 363A00000X Physician Assistant (Licence: WV 2312) | |
| Enumeration Date | 2020-01-04 |
| Last Update Date | 2024-07-17 |