| NPI | 1346942554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009201) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 2712) |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2024-01-09 |