| NPI | 1265165674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009070) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-07-04 |
| Last Update Date | 2023-02-09 |