| NPI | 1508503335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110009035) |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2023-04-14 |