| NPI | 1265097786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007095) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2021-12-03 |