| NPI | 1407430549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008085) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062367) |
| 363A00000X Physician Assistant (Licence: PA OA005610) | |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2023-11-13 |