| NPI | 1477179620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007381) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007590) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2024-12-13 |