| NPI | 1659157618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009630) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0110009630) |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2024-02-09 |