| NPI | 1508695693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110010410) |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2024-10-23 |