| NPI | 1679105530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007652) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2024-03-07 |