| NPI | 1598129108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005694) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06363) |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2023-12-29 |