| NPI | 1598376600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110007146) |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2022-02-11 |