| NPI | 1548740616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007167) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55877) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2024-09-16 |