| NPI | 1295387132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007329) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007241) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2023-08-08 |