| NPI | 1447820493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-008087) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4655) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-09-25 |