| NPI | 1578129359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-006714) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2023-12-26 |