| NPI | 1346898715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006470) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56365) |
| 363A00000X Physician Assistant (Licence: WA 60913595) | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2021-12-15 |