| NPI | 1609338961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006611) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006611) |
| 207Y00000X Otolaryngology (Licence: VA 0110006611) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2024-08-29 |