| NPI | 1699236026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 60888857) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2022-05-18 |